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HomeMy WebLinkAbout2864 VIA CONQUISTADOR; ; CBR2022-0713; Permit                                                     (Cityof Carlsbad I ( City of RESIDENTIAL BUILDING PERMIT Plan Check Est. Value Cflsbad APPLICATION PC Deposit B-1 Date Job Add resf <i¼, '-{ \) I A- 1...- APN: 2 l z_541_t_..(, 6 o ~ a N Q. tJ I':> T A--0 0 <Lsuite: Year Built: ~ l CT /Project #: Lot#: Fire Sprinkl~rs: OvEs(ljiNo Air Conditioning:,©YES O NO Electrical Panel Upgrade: O vES~O BRIEF DESCRIPTION OF WORK: Mk':7TILfL-D~ [, ~ F0 cJ)e L I f2_J::,AA..OJ5-b4,..)D D .EtfG\-lF 10 Yr~ / 0 I D Additibn/New: Living SF, Deck SF, Patio SF, Garage SF Is this to j reate an Accessory Dw ellingUnit? 0v 0 N New Fireplace? 0v Q N,ifyeshowmany? __ O Remo,el: SF of ffected area Is the area a conversion or change of use? O v O N D Pool/Spa: SF Additional Gas or Electrical Features? □solar: I KW, fl 1odules, Mounted:0 Roof 0 Ground, Tilt: 0 vO N, RMA:0Y 0 N, I Battery:O Y ON, Panel Upgrade :0 Y 0 N D Rero ~: ef'Plum1 ng/Mechanical/Elect1 1cal fV'B.,J 5 <i-J IL-SL 2 (~ C?-U A-\_ v C:: , Tl LC D Only: 1 ther: I I I I This permit i~ to be issued in the nam e of the Property Owner as Owner-Builder, licensed contractor or Authorized Agent of the owner or cor tractor. The person liste( as the Applicant below will be the main point of contact throughout the permit process. PROPERTY 1 i>WNER APPLICANT D PROPERTY OWNERS AUTHORIZED AGENT APPLICANT (ii Name:hJ i----f( __ e--JJ E-D---1 ..... 0 ""'--Name: Home Remodelinq Center Address: Zk>e, '-1 V (A-Co~ I 'n-4-9 I') n. Address: 830 Los Vallicitos Blvd. City:~'--'> f;,f-<) State: r ,l._ Zip:9'2.0v CZ_ City: San Marcos State:CA Zip:92069 Phone: I Phone: 7606682033 Email: I Email: chris@homeremodelinQcenter.com I □ APPLICANT 0 DESIGN PROFESSIONAL APPLICANT CONTRACTOR OF RECORD Name: Horr1 e Remodeling Cer er Name:Same Address: Address: City: State: Zip: City: State: Zip: Phone: Phone: Email: I Email: Architect Stt te License: State License/class: 831553 B Bus. License:BLOS1236517 Ph: 760·602•2719 Fax: 760-602·8558 Email: Building@carlsbadca.gov 1635 Faraday Ave Carlsbad, CA 92008 I I 1 REV. 08/20 IDENTIFY rHO Will PERFORM HE WORK BY COMPLETING (OPTION A) OR (OPTION B) BELOW: (OPTION A): LICENSED CONTRA OR DECLARATION: I hereby affirm under penalty of per/ ry that I om licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busi1ess and Professions Cod , and my license is in full force and effect. I also affirm under penalty of perjury one of the following declarations: 0 1 have and will maintain a certificate of co sent to self-insure for workers' compensation provided by Section 3700 of the labor Code, for the performance of the work which t1s permit is issued. Policy No.-1---------------------------------------- [i] I have and will maintain worker's compen tion, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' q>mpensation insurance carrier Policy No.HOWC 979397 nd policy number are: Insurance Company Name: _N_org_a_u_rd_ln_s_u,_. c_o_. _______________ _ Expiration Date: _0_712_0_21 ____________ _ 0 Certificate of Exemption: I certify that in th performance of the work for which this permit 1s issued, I shall not employ any person in any manner so as to become subject to the workers' compensation Laws o California. WARNING: Failure to secure workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100, 00.00, in addition the to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. CONSTRUCTION LENDING AGEN Y IF ANY: I hereby affir1 that there is a construction le ding agency for the performance of the work t s p r Lender's Name: _________ --+ ___________ Lender's A dre : +=t:J-ft----===--=------------ CONTRA<;TOR PRINT: Chris C sta SIGN: DATE: c--z.s--u,:z_ I ------4--------~~-=-'-.....::C....------- ( o PT 10 NB): OWNER-BUILDER D CLARATION: I hereby affirm that I am exemp t fro Contractor's License Law for the following reason: 0 I, as owner of the property or my employe s with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Co ractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provid d that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder wil have the burden of proving that he did not build or improve for the purpose of sale). 0 I, as owner jf the property, am exclusively ontracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an wner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License law}. 01 am exempJunder Business and Profession Code Division 3, Chapter 9, Article 3 for this reason: D•owner BuilJer acknowledgement and veri 1cation form" has been filled out, signed and attached to this application. 0 Owners "Authorized Agent FormH has bee filled out, signed and attached to this application g,ving the agent outhor,ty to obtain the permit on the owner's behalf. By my signaturJ below I acknowledge that, ex pt for my personal residence in which I must have resided for at least one year prior to completoon of the improvements covered by this permit, I canno legally sell a structure that I have built as an owner-builder 1f 1t has not been constructed in its entirety by licensed contractors. I uqderstond that o copy of the op licoble low, Section 7044 of the Business and Professions Code, is ovolloble upon request when this opplicotion is submitted or ot,the following Web site: http:// ww.leginfo.ca.gov/colow.html. I OWNER PRINT: -------+-----SIGN: __________ DATE: ______ _ APPLICANTICERTIFICATION: SIGN TURE REQUIRED AT THE TIME OF SUBMITTAL By my signature below, I certify that: Io the property owner or State of California Licensed Contractor or authorized to act on the property owner or contfctor's behalf. I certify tho I have read the application and state that the above information is correct and that the information on the plans is acf urate. I agree to comply wi h all City ordinances and State laws relating to building construction. I hereby authorize representative of the City if Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY F CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID f'TY IN CONSEQUENCE OF T GRANTING OF THIS PERMIT. OS~A: OS A permit is required for excavations over 5'0' deep and demolition or construction of structures o er 3 stories ,n height. APPLICANI PRINT: Chris Cost SIGN1 ::;....;;;;..._~------DATE: Z --z_s---1-0 2.-2- 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Bu1lding@carlsbadca.gov 2 REV. 08/20                                                                           {city of Carlsbad                       